Presenting Author: Dr. Kshitij M Parekh, Resident: Dr. Vasantrao Pawar Medical College, Guide: Dr. Dhiraj Balwir, Associate Professor: Dr. Vasantrao Pawar Medical College

1. Presenting Author: Dr. Kshitij M Parekh
Resident, Dr. Vasantrao Pawar Medical College
Guide: Dr. Dhiraj Balwir
Associate Professor
Dr. Vasantrao Pawar Medical College

2. A Rare Case Of Orbital Myiasis

3.  A maggot is the larva of a fly (order Diptera);
most commonly the larvae of Brachyceran flies,
such as houseflies, cheese flies, and blowflies.
 ‘Myia’ is a Greek word meaning ‘fly’. ‘Myiasis’ is
a condition caused by infestation of the body by
maggots. We report a case of orbital myiasis of
the eyelid.
 Ophthalmomyiasis progresses rapidly and can
completely destroy orbital tissues within days.
 It also destroys the bony tissues extending the
infection to the brain.

4.  A female Hausabai Bhor, 75 years old with
complaints of pain and feeling of some
moving object in the left eye of 5 days
duration.
 One month before she had a history of dog
bite on the left eye.
 She did not receive any treatment prior.

5.  On ocular examination
 The patient was having visual acuity 6/9 in both eyes.
 She had a lacerated wound over both the eyelids of
the left eye.
 There was severe degree edema and derangement of
the anatomical configuration of upper eyelid.
 The wound was filled with pus.
 The nasal bridge was also damaged
 Lacrimal sac was missing.
 The conjunctiva was congested.
 Cornea showed mild edema.
 Ocular movements were normal.
 The right eye was normal

6.  CT-scan reports showed intact bony walls of
the left orbit.
 Hemogram showed mild leucocytosis.
 Surgical debridement under local anesthesia
was done.
 The larvae were removed with the help of
forceps after instilling turpentine oil..

7.  The pus and exudates were cleared off till the
healthy tissue was reached.
 On removal of the pus from the wound the black
headed larvae were seen.
 Turpentine oil forced the aerobic larvae to surface
for air, at which time they could be captured by
forceps.
 Utmost care was taken to remove each of the larvae
completely so as to prevent foreign body reaction.
 Additionally, lidocaine was injected into the floor of
the cavity
 After 3 days the wound was free of larvae and started
healing.

8.  Around 15-20 larvae were captured and the
wound was filled with 10% povidine iodine
solution.
 Intravenous cefotaxime 1gm b.d. was
started.
 Tetanus immunization was done.
 Fresh granulation tissue started appearing.
 The edema subsided gradually by the 7th day.
 There was complete resolution of the
oedema by the 15th day.
 The wound healed by secondary intention.

9.  No delay should be done in case of treating the
open wound and it should be covered to prevent
access to flies.
 Wound should be properly managed post-
operatively with antiseptic dressings and
antibiotics..
 There is no absolute method for protection
against myiasis.
 Adequate personal hygiene and proper care of
wounds helps to a large extent in preventing this
catastrophe.
 Treatment of debilitating underlying conditions if
any needs specific attention.